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Another Indiana Medicaid Stalwart Said to Be in Line for Top Job

Yet another Indiana Medicaid stalwart could be set to help guide the federal health
program for the poor.

Brian Neale, who most recently served as the executive director of the congressional
Joint Economic Committee, worked alongside Centers for Medicare & Medicaid Services
nominee Seema Verma as a key driver of the Hoosier state’s Medicaid expansion. Now
the Trump administration is eyeing him to take the reins under Verma’s lead of the
Center for Medicaid and CHIP Services.

Career staff at the federal Centers for Medicare &
Medicaid Services have said Neale has been internally identified as the new Medicaid
director, Manatt, Phelps & Phillips partner Cindy Mann told Bloomberg BNA. Mann held
the role under the Obama administration before joining the firm.

At a time when drastic overhauls to Medicaid financing and coverage are on the horizon,
Neale would be responsible for the $550 billion safety-net insurance, which covers
more than 70 million people. He also would oversee the Children’s Health Insurance
Program, which is set to run out of funds later this year if not renewed.

Neale joined the congressional Joint Economic Committee in June 2016 after working
as a health-care policy director since 2013 in the Indiana Office of the Governor.
He previously was a legislative assistant for then-Rep. Mike Pence, according to Bloomberg
Government.

Neale could not be reached for comment March 1.

Department of Health and Human Services spokesman Matt Lloyd said the agency is not
confirming personnel.

The nomination of Verma, picked to head the larger CMS agency, will go before the
Senate Finance Committee for a second vote March 2. An initial vote March 1 resulted
in a tie vote and failed to advance her nomination to the full Senate.

Background

“While HIP [Healthy Indiana Plan] has never touted itself as some sort of national
silver bullet, it continues to serve as an example for states having similar interest
in re-aligning Medicaid with the broader objective of individual empowerment,” Neale
and Verma wrote in a joint Health Affairs column Aug. 29, 2016. “Enhancing state flexibility,
particularly with respect to the low-income, able-bodied population, can help cultivate
further state innovation, leading to a stronger and more effective Medicaid program.

They called the state’s Healthy Indiana Plan 2.0 “just the beginning.”

Lining up under former state colleagues Mike Pence (then Indiana governor, now vice
president) and Verma, the leadership triumvirate could see Indiana’s unique, conservative
vision for Medicaid as a model for the country.

Under the Affordable Care Act, Indiana’s first-of-its-kind waiver grew coverage for
families living below 138 percent of the federal poverty level in 2015. About 400,000
residents are currently covered.

The Indiana plan also features stricter, tighter features than most state waivers,
such as personal-responsibility cost sharing (premiums and copayments), health savings
accounts, rewards for healthy behaviors, tiered coverage and six-month lock-out eligibility
windows for a failure to pay premiums.

Its success has been hotly contested in recent months, as Indiana has resubmitted
a waiver request in January.

To contact the reporter on this story: Victoria Pelham in Washington at
vpelham@bna.com

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